MARICOPA COUNTY OFFICE OF THE MEDICAL EXAMINER

ROLES, RESPONSIBILITIES AND CAPABILITIES

Melanie RouseChief Medicolegal Death Investigator

“THE MISSION OF THE MEDICAL EXAMINER IS TO PROVIDE PROFESSIONAL MEDICOLEGAL DEATH

INVESTIGATIONS OF INDIVIDUALS DYING UNDER STATUTORILY DEFINED CIRCUMSTANCES, THE

RESULTS OF WHICH ARE COMMUNICATED INDEPENDENTLY TO RELEVANT AGENCIES,

INDUSTRIES, AND MEMBERS OF THE PUBLIC SO THEY CAN RECEIVE ACCURATE, TIMELY, AND

EFFECTIVE COMMUNICATIONS THAT ENHANCE THE PUBLIC’S SAFETY AND HEALTH.”

HISTORY OF THE OME

Maricopa County Medical Examiner’s Office is the oldest functioning medical

examiner’s office in Arizona.

The first Maricopa County M.E. was named in 1957.

Until 1975, most of Arizona had a coroner system in which the local Justices of the Peace served as the

county coroner

The Maricopa County Forensic Science Center is a state of the art medical examiners office, about 14 years old, and approximately

68,000 sq. ft. in size.

We have 3 floors, the top level is our toxicology department, the middle floor are offices and administration, and the entire lower level

(basement) is where the bodies are admitted, stored and where the examinations are performed.

FACTS ABOUT THE FORENSIC SCIENCE CENTER

FORENSIC SCIENCE CENTER

Total of 12 autopsy tables, ten in the main autopsy room, and two tables in the special procedures room for

potential infectious disease cases, decomposed, and burned bodies.

Currently have 14 forensically-trained and board-certified forensic pathologists who perform a minimum

of twelve exams per day. (16-18 on average)

Have a forensic odontologist and a forensic anthropologist on staff.

FACTS ABOUT THE FORENSIC SCIENCE CENTER

We currently have 26 full time forensic investigators who cover all of Maricopa County, with three small SUVs, two

equipment trailers and we have three 4x4 trucks which can hold two bodies each

Decedents are transported by a contracted company

The office is open 24/7 with an investigative and admitting office staff, and a on-call pathologist available for any questions (scene calls), tissue donations, or for various decision making

capabilities.

Total staff at the OME is approximately 100 employees

INVESTIGATIVE AND SUPPORT STAFF AT THE OME

We have 10 full-time forensic toxicologists who performed over 85,000 drug tests last year on most of the decedents.

The toxicology laboratory does over 98% in- house testing and the testing turn-around time for the pathologists is approx 98% in 45

days.

We also have an in-house, histology laboratory which produces glass slides of tissues for microscopic evaluation by the pathologist.

The laboratory is the only lab in Arizona to be certified by the American Board of Forensic Toxicology (ABFT)

TOXICOLOGY STAFF

There are 3 large storage coolers at the OME with the totalnormal* storage capabilities of approximately 143 bodies, placed on

racks.

In an event of an emergency (surge or mass disaster), we have an additional storage (overload) cart, racks and floor capacity for

another 100-125 bodies. *Note 4-6 mo/year at or near capacity (avg. 40-60%)

We have additional non-cooler storage in the basement of the parking structure for supplies, in the event of a mass disaster, where several thousand body bags and personal protective equipment are

stored.

STORAGE AT THE MEDICAL EXAMINERS OFFICE

Directly across from the OME, there are 2 large county-owned lots, separated by an alley, for possible

refrigerated trucks/Conex containers, additional storage with security and for media coverage.

Easy access for bodies to enter the OME via a tented walkway from the trucks.

These 2 lots and a temporary (mobile) morgue in the underground parking structure makes for easy exchange

of bodies without interference of the main autopsy suites for its daily capacity.

* Many Logistical Challenges (Jurors, 8th Ave)

PARKING LOT ACROSS FROM OME

UNDERGROUND PARKING STRUCTUREFOR TEMPORARY OR MOBILE MORGUE

UNDERGROUND PARKING STRUCTUREFOR TEMPORARY OR MOBILE MORGUE

Incident/Unified Command

Operations Section Chief

Finance/Admin. Section Chief

Planning Section Chief

Logistics Section Chief

PIO

Liaison Officer

Safety Officer

Fatality ManagementBranch Director

LEBranch Director

Morgue Group Supervisor

SARBranch Director

Family Assistance Center

Group Supervisor

Incident SiteGroup Supervisor

Fire Branch Director

ForensicUnit Leader

Admitting/ProcessingUnit Leader

Radiology

DNA

Anthropology

Odontology

Fingerprints

Pathology

Decontamination

Storage

Personal Effects

Admitting

Triage / ERT

Tracking

Victim Identification Group Supervisor

Photography

Morgue OPS-Mass Fatality ICS Chart that can be Applied at Local–Federal Level

Maricopa M.E.’s - 10Capacity - 135

Mohave OMEM.E.’s – 1 Capacity - 4

Pima OMEM.E.’s – 5Capacity – 60Covers 9 counties

Yavapai OMEM.E.’s – (contract)Capacity - 8

Coconino OMEM.E.’s – 2Capacity – 4Covers Navajo Cty.

Mohave OMEM.E.’s – 1Capacity - 4

Yuma OMEM.E.’s – 1Capacity – unknownLimited functions

Maricopa OMEM.E..’s – 14

Capacity - 143

Medical Examiner infrastructure statewide – No statewide system or centralized coordinationHistorically – managed with personal relationships and professional commitment with contracts

Resource Partners Public Health: Vital Records and OPR, we have a strong, close partnership with daily and ongoing event planning

The Department: Funding and equipment opportunities allowed for OME growth and preparedness for fatality management–Digital X-ray project

Outside Agencies: Working with MIHS and MC Community College for additional cold storage and alternative location to set up surge morgue. Staffing: Cross training and collaborative efforts for collecting information from family (anti-mortem data) interviews and procedures. MCDEM, AZCHER, FH board, Air Quality

OME

Scene operations

Disaster Morgue

operations

Coordination at Trauma

centers

Family Assistance

Center

Role of OME is more involved than coming in at the end…..

~4 Million people

9224 sq. miles

MARICOPACOUNTY

9000+ Deaths reported last year

5903 Jurisdictional casesCY17

~4700 Postmortem examinations

92 Hospitals and in-patient facilities

34 Law enforcement agencies

Public Health

OSHA, NTSB, FAA

Insurance industry

Anatomical gift industry

Aftercare industry (over 200 funeral homes)

Police

Hospital/facility/hospice

Funeral Home

Vitals

Death Certificate Transit Permit Review and Cremation Authorizations by on-call OME pathologist

HOW DEATH REPORTS ARE RECEIVED:

Title 11, Chapter 3, Article 12, Statute 11-591

“Medical examiner” means a forensic pathologist who performs or directs the conduct of death investigations

“Alternate medical examiner” means a physician who has training and competence in the principles of death investigation and who performs or directs the conduct of death investigations.

Title 11, Chapter 3, Article 12, Statute 11-593

A. Any person having knowledge of the occurrence of the death of a human being including a fetal death that is required to be reported pursuant to subsection B, of this section shall promptly notify the nearest peace officer of all information in the person's possession regarding the death and the circumstances surrounding it.

Title 11, Chapter 3, Article 12, Statute 11-593

B. Reporting is required in the following circumstances:

1. Death when not under the current care of a health care provider as defined pursuant to section 36-301.

2. Death resulting from violence.

3. Unexpected or unexplained death.

4. Death of a person in a custodial agency as defined in section 13-4401.

Title 11, Chapter 3, Article 12, Statute 11-593

B. Reporting is required in the following circumstances:

5. Unexpected or unexplained death of an infant or child.

6. Death occurring in a suspicious, unusual or nonnatural manner, including death from an accident believed to be related to the deceased person's occupation or employment.

Title 11, Chapter 3, Article 12, Statute 11-593

B. Reporting is required in the following circumstances:

7. Death occurring as a result of anesthetic or surgical procedures.

8. Death suspected to be caused by a previously unreported or undiagnosed disease that constitutes a threat to public safety.

9. Death involving unidentifiable bodies.

Based upon the information provided the investigator will either Decline, Accept or make

the case a CNA (Case Not Admitted)

JURISDICTION

In some cases additional information may be sought from LE, NOK, other facilities or

records to determine jurisdiction

QUESTIONS?

Melanie RouseChief Medicolegal Death InvestigatorWork Days Monday-Friday 0700-1500rousem@mail.maricopa.gov602-506-8230